The present disclosure relates generally to medical devices. More particularly, it relates to a fenestrated endoluminal device and system and method of deployment for implantation within a human or animal body for repair of damaged vessels, ducts, or other physiological pathways.
Using endoluminal devices, such as stent grafts, to treat aneurysms is common in the medical field. Stent grafts are deployed by accessing a vasculature with a small incision in the skin and guiding a delivery system to the target area. This intraluminal delivery is less invasive and generally preferred over more intrusive forms of surgery. Multiple stent grafts may be implanted using intraluminal delivery to provide a system of interconnected stent grafts.
At times, the aneurysm has engulfed a main vessel and branch vessels extending from the main vessel. In these cases, it may be necessary to deploy one or more stent grafts in a major vessel (e.g., the aorta) at or near an intersecting branch vessel (e.g., innominate, carotid, subclavian, celiac, SMA, and renal arteries). In these cases, a stent graft may be provided with one or more fenestrations so that the stent graft can overlap the branch vessels without blocking flow to these vessels. Once the stent graft is placed in the main vessel, it may be necessary to provide interventional access between the main vessel and a branch vessel. For example, a physician may desire to deliver additional interventional catheter devices carrying balloons, stents, grafts, imaging devices, and the like through the fenestration.
However, before such a catheter device can be delivered through the fenestration to a target vessel, a guide wire must be provided and delivered through the fenestration to the target vessel. Typically, this requires multiple steps. First, the physician must deliver and navigate a set of catheters and wires to pass a guide wire through the fenestration. Once the fenestration is cannulated, the physician must then deliver and navigate a separate set of catheters and wires to pass a guide wire into the target vessel. These procedures are labor intensive, involve manipulating multiple wires in a vessel at the same time, and depend heavily on the skill of the physician to cannulate both the fenestration and the target vessel. The steps become even more complicated and numerous when the physician needs to cannulate more than one fenestration and more than one target vessel. In addition, the complexity of the procedure increases as the number of cannulating wires increases, since the physician must take precaution to ensure that the multiple wire ends do not become entangled, or that they do not inadvertently contact and damage the prosthesis or a vessel wall. When the branch vessels are the renal arteries and the SMA, there are additional challenges. The physician will need to withdraw the sheath entirely via a contralateral sheath. Afterwards, the SMA is manually cannulated via a contralateral sheath. The renal arteries are then cannulated following SMA cannulation.